Health experts are advising parents to have a management plan in place for their children’s asthma as COVID restrictions lessen, leaving them more vulnerable to respiratory illness this winter.

The call comes as New Zealand’s 2021 influenza vaccine programme, an essential tool in the management of asthma, is set to begin this month.

While new international research has found a global reduction in paediatric asthma hospitalisations may be due to pandemic management measures such as lockdowns, social distancing, mask wearing and better hygiene practices, with some of the highest rates of asthma in the world Kiwi parents are being reminded to stay vigilant[1][2].

Massey University epidemiologist and Professor of Public Health Jeroen Douwes says although New Zealand was not part of the new global research, anecdotally GPs here are also seeing fewer asthma exacerbations in patients which could also be attributed to COVID precautionary measures.

Asthma is a non-contagious, respiratory disease that affects the airways in the lungs, and may restrict breathing. Symptoms can include coughing, wheezing and shortness of breath – and can be caused by exposure to an allergen or a viral illness such as a cold or flu.

Latest New Zealand figures show a 45% increase in the rate of Kiwi children hospitalised with asthma over the past two decades – with around 6,000 children under the age of 15 admitted to hospital each year[3].

Professor Douwes says as the vaccine rollout continues and we move back to a more normal way of life, those living with asthma will once again be at risk during the winter months.

He says viral illnesses such as a cold or flu are a significant cause of asthma events and easing of COVID restrictions including a lack of social distancing and poor adherence to hand-washing will once again put children living with asthma at greater risk of contracting respiratory infections.

“We are struggling to use the tracer app on our phones, let alone use hand sanitisers, so I think this will be a typical winter with a high number of exacerbations and hospitalisations as we stop social distancing.

“Parents need to be vigilant, while it may seem like their child’s asthma is well controlled, this could be largely due to lack of environmental triggers as they have been in lockdowns or socially isolated, and there has not been any flu,” he says.

Douwes says with winter approaching we need to be mindful of asthma triggers such as viral infections.

“The message is we need to remind people that as we move into the winter season with more respiratory infections, we need to be alert, we need to make sure that children take their medication, because respiratory infections are obviously a major reason for asthma exacerbation,” he says.

Douwes says we need to ensure parents, children living with asthma, schools and school nurses are aware of the needed medications and asthma management plan is in place.

He says there is a significant ethnicity based disparity in New Zealand with Maori aged 5–34 almost twice as likely as non-Maori to have been hospitalised for asthma.

“We need to take asthma much more seriously, we need to do better collectively in getting children with asthma to use the medication intended. This is particularly relevant for Maori and Pasifika children who have the highest number of hospitalisations. We need to do better.”

“People also need to be aware of what can set off an asthma attack with triggers including a cold or virus, indoor temperatures cooler than 18 degrees celsius, damp and mould,” he says.

A recent Sensitive Choice study found a sixth (15%) of the 1,000 New Zealand survey respondents are living with asthma and more than half (52%) of respondents say they or a family member has taken a prescription or over-the-counter medication for asthma or allergies at some stage. One in every seven (14%) adults say they or a family member had been hospitalised as a result of asthma or allergies.

Professor Douwes says the National Asthma Council Sensitive Choice Programme have prepared the following checklist to help children with asthma reduce their chances of an exacerbation:

  • Schedule an asthma check-up with your health provider.
  • Share a copy of your child’s up-to-date written Asthma Action Plan with school staff and after school carers.
  • Ask your child to let school staff know when their asthma is flaring up.
  • If your child has exercise induced asthma, ensure they take their reliever before sport.
  • Explain to your child their asthma triggers and why it is important to avoid them.
  • Make sure your child is taking asthma prevention medicine, as prescribed.
  • Check that your child knows how to effectively use their inhaler by themselves (if old enough), or with help.
  • Teach your child how to use a spacer with their inhaler
  • Get the seasonal flu shot every year for your child and family members.

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